Incidence of lateral femoral cutaneous nerve lesions after direct anterior approach primary total hip arthroplasty – a literature review - 30/11/21
Highlights |
• | Lateral femoral cutaneous nerve lesions after direct anterior approach hip arthroplasty are a frequent and, in the past, often underestimated complication. |
• | Lateral femoral cutaneous nerve lesions occur in 0–83% of direct anterior approach hip arthroplasty. |
• | Mean incidence rates of studies focusing on lateral femoral cutaneous nerve lesions is 31%. |
• | Mean incidence rates of studies not focusing on lateral femoral cutaneous nerve lesions is 3.8%. |
• | Reported incidence rates have increased in recent years. |
Abstract |
Introduction |
Lesions of the lateral cutaneous femoral nerve are a reported complication of the direct anterior approach (DAA) for total hip arthroplasty (THA). Little is known about the incidence rates of this lesion. The goal of this study was to answer the following questions: (1) Is the true incidence rate of LFCN lesions after DAA THA known? (2) What are the reasons for the wide range of reported incidence rates in the literature? (3) Are surgeons increasingly aware of the significance of LFCN lesions?
Methods |
A US Medical Library of Medicine database search was performed for DAA THA. In total, 1261 search results were screened for reported LFCN lesions.
Results |
Forty-five studies were included reporting LFCN lesions rates of 0–83%. Subgroup analysis for studies with (group A, 6 studies, n=1113 cases) and without (group B, 39 studies n=16,741) primary focus on the LFCN lesions was performed. Incidence in group A ranged from 14.8–81% (mean 31%) and 0–83% (mean 3.8%) in group B. The difference between the groups was significant (p=0.005). No uniform and time sensitive definition of postoperative LFCN lesions was found in the literature. An analysis of the publication year and the discovered incidence rate showed an increase of incidence rates [rs=0.521 (p<0.001, two-tailed)] over time.
Conclusion |
Despite the absence of a uniform definition: LFCN lesions after DAA THA are a frequent and, in the past, often underestimated complication.
Level of evidence |
IV; systematic review of level II to level IV studies.
Le texte complet de cet article est disponible en PDF.Keywords : Lateral femoral cutaneous nerve (LFCN), Direct anterior approach (DAA), Total hip arthroplasty (THA), Review, Minimal invasive hip replacement
Plan
Vol 107 - N° 8
Article 102956- décembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.